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NPI 1659292993

NPI 1659292993 : JOHNSON RANCH HOLDINGS PLLC INNER PATH THERAPY : MAGNOLIA, TX

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General NPI Number Information
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    NPI Number           |    1659292993
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    Entity Type          |    Organization 
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    Legal Business Name  |    JOHNSON RANCH HOLDINGS PLLC INNER PATH THERAPY 
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Dates
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    Enumeration Date     |    07/23/2026
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    Last Update Date     |    09/16/2026
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Provider Practice Location Address
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    Address Line         |    5419 TORY ANN DR 
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    City                 |    MAGNOLIA
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    State                |    TX
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    Zip                  |    77354-5850
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    Country              |    US
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    Telephone            |    254-458-4528
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    5419 TORY ANN DR 
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    City                 |    MAGNOLIA
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    State                |    TX
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    Zip                  |    77354-5850
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    Country              |    US
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    Telephone            |    254-458-4528
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     KIMBERLY BROOKE JOHNSON 
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    Credential           |    LPC
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    Telephone            |    254-458-4528
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101YP2500X
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    Taxonomy Name        |    Professional Counselor
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    License Number       |    
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    License Number State |    
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